CAJ | 학술논문

目的：探讨精神科临床护理路径实施过程中病例脱组的原因并制定应对措施降低脱组率。方法将2012年12月1日-2013年3月31日入组患者（对照组）的脱组现象进行回顾性调查分析，明确脱组原因并制定应对措施，以此对2013年4月1日-7月31日入组患者（干预组）进行干预。将两组之间的脱组率、脱组原因等进行比较分析。结果对照组脱组率为11．3％，干预组明显下降为5．1％，两组比较差异有统计学意义（χ2＝5．747，P＜0．05）。主要脱组原因中，“家属或患者认为病情好转而出院”单项因素在干预前后的比较差异有统计学意义（2．3％比0．0％，χ2＝5．376，P＜0．05）。结论明确脱组原因，有针对性地干预可避免因素，可降低脱组率，完善变异管理，帮助精神科临床护理路径的开展。
목적：탐토정신과림상호리로경실시과정중병례탈조적원인병제정응대조시강저탈조솔。방법장2012년12월1일-2013년3월31일입조환자（대조조）적탈조현상진행회고성조사분석，명학탈조원인병제정응대조시，이차대2013년4월1일-7월31일입조환자（간예조）진행간예。장량조지간적탈조솔、탈조원인등진행비교분석。결과대조조탈조솔위11．3％，간예조명현하강위5．1％，량조비교차이유통계학의의（χ2＝5．747，P＜0．05）。주요탈조원인중，“가속혹환자인위병정호전이출원”단항인소재간예전후적비교차이유통계학의의（2．3％비0．0％，χ2＝5．376，P＜0．05）。결론명학탈조원인，유침대성지간예가피면인소，가강저탈조솔，완선변이관리，방조정신과림상호리로경적개전。
Objective To explore the causes of dropping off in the psychiatric clinic nursing pathway , and to develop efficient coping strategies to prevent dropping off .Methods A retrospective analysis was performed to determine the causes of dropping off amongst patients within the control group ( from December 2012 to March 2013 ) .The findings were used to devise efficient coping strategies which were then applied to the intervention group ( from April to July 2013 ) .The rate of dropping off and the reasons for dropping off were compared between the control group and intervention group .Results The rate of dropping off of the intervention group was 5.1%, which was significantly lower than 11.3%of the control group (χ2 =5.747,P<0.05).Main reasons for dropping off included “Discharged due to patient” or “Discharged due to patients ’ family”.There were significant differences compared with the single factor analysis (2.3%vs.0.0%;χ2 =5.376,P<0.05). Conclusions Major reasons for dropping off were identified and appropriate coping strategies were implemented .These interventions were shown to help lower the dropping off rate , improved the variance management techniques , and could promote the development of psychiatric clinical nursing pathway .